Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | MD043405 | DC |
NPI | 1043429459 |
---|---|
Provider Name | Melissa Martinez Anastacio |
First Address | Washington, DC 20010-3017 |
Second Address | Washington, DC 20010-3017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 30/09/2015 |